Lane 4 Swim Camp - One form per Swimmer

Please Complete One form per swimmer

ALL swimmers MUST be currently registered with Swim Alberta in order to participate. If your swimmer is NOT registered with an Swim Alberta affiliated club for the 2024/25 season, there will be an additional insurance fee of approximately $30.

Swimmer Information - Please complete one form per swimmer attending camp - Thank you

Swimmer First Name :*

Swimmer Last Name:*

Gender:*

Date of Birth:*

Camp Options

Week 1: Mon Aug 11 to Fri Aug 15 - 8am-12pm at MNP Centre

Registration:

Week One

Week 2: Mon Aug 18 to Fri Aug 22 - 8am-12pm at MNP Centre

Registration:

Week Two

Grand Total:

Personal Information - One form per swimmer please

E-Mail:*

Valid e-mail is required

Parent First Name:*

Parent Last Name:*

Address Line 1:*

Address Line 2:

City:*

Prov/State:*

Postal/Zip Code:*

Phone:*

Are you a member of KSC

Yes
No

Are you hoping to transfer?

Yes
No

Name of your home club

Is there anything you`d like us to know about your swimmer?

Comments:

Remaining Characters

1000 Character Limit

Payment Options

All payments are due July 15, 2025. For registrations after July 15, 2025, payment is due upon completion of registration.
PAD and credit card payments will automatically be charged on that date. 
E-transfers must be received on or before July 15, 2025.
No refund for cancellations within 14 days of camp start date.

Method of Payment:*

e-transfer to : vpfinance@killarneyswimming.com
Pre-Authorized Debit (For existing KSC members ONLY)
Credit Card (Subject to 3%)

Name on Card

Card Number

Expiry Month:

Expiry Year:

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